Dentistry: What’s it Like in Prison

Last week we discussed the news that California will lay off a number of prison dentists. This week, we’ll address the reality of being a practicing prison dentist, and why prison dentists in California are paid so much more than in other states.

Many doctors shy away from prison dentistry, assuming that working with inmates would be a nightmare. But an excerpt from a letter seeking dentists for Correctional Dentistry reads, “Our patients are in need of dental care and are the most appreciative patients you will ever have the chance to serve. Most have never had the opportunity to seek dental care until now.”

And many dentists agree that it’s actually a relatively pleasant patient population. “In my experience, inmates are generally among the most cooperative patient demographics I’ve ever worked with,” commented one dentist.

But prison dentistry isn’t for every dentist. “Lots of extractions, exams, amalgams, anterior composites. No dental crowns and dental bridges, no removable dentures, rarely do a root canal (usually extract). The patients are often Hep C+, many are HIV+, etc,” said one doctor. “Some inmates are looking to stir up trouble. However, if you are nice to them, word gets around because a lot of these guys are treated like dirt in the system. There’s a niche to be filled in prison dentistry. It’s not for everyone, but if you can make it work, more power to you.”

And practicing dentistry in a prison is quite different from running a family and general dentistry practice. “The most common mistake of civilian dentists is in trying to over-treat the patients with complex private practice treatment plans,” added another. “Dentists with a military or a public health background are better adapted to correctional dentistry, due to the similarity of the practice model. Remember that resources are limited and you are responsible for the oral health of every inmate in your institution. What you do for one must be done for all.”

Why California is a good state for prison dentists

Prison dentists in California are paid much more generously than in other states. “I looked online at dept. of corrections jobs around the country,” commented another dentist. “It looks like California pays about 2-3 times as much as anywhere else in the country.” And while the cost of living is higher in California, there’s something more going on here.

One dentist offers an explanation. “Why is the State of CA paying prison dentists a lot of money? A few years ago there was an inmate class action lawsuit against the state regarding the dental care being provided in prisons (Perez vs Tilton, et al.)… Apparently the quality of dental care was so bad and the dentists were getting paid so little (compared to private practice), thus the lawsuit and settlement took place… The Perez lawsuit will provide better quality dentists because the salaries are much higher and better facilities. As you can imagine, there’s a lot more competition applying for these prison dentist positions here in CA, because of these changes.”

Curious about what’s involved in becoming a prison dentist in California?

California Public Employees’ Safety Retirement System (Exempt from paying into the Federal Social Security System)

Not a bad deal!

“We are in a recession,” continued the dentist quoted above. “I know I’m not the only one who is/was struggling to run a solo private practice, especially in CA… I know the politics of this whole situation is messy, but the bottom line is, I have to support my family. My wife and I were both slaving in our private office before we sold it. Our dental office was affecting not only our lives, but our children’s lives. Like I mentioned before, we felt we were slaves to the office, instead of proudly owning and running it.”

Want to know more?

“I just got hired on as a staff dentist here in Northern CA. I no longer have the small business headaches and I feel I’ll finally be getting paid what I’m worth and there’s room to move up the ladder if I want…

“Just wanted to let CA (and beyond) dentists know there are other ways to make a good living besides private practice. Working at a prison may not have the glamorous image like owning a practice, but for some folks it makes a great alternative.”

it would be interesting to know what that dentist and his wife do now. i.e., if being in private practice was unrewarding, what is “better” in his view? Being an associate? Being a public health provider? Switching to another career?

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